Department of Defense (DoD)

The DoD and VDH both maintain local ESSENCE installations to monitor the health status of their military and civilian populations, respectively, and submit syndromic surveillance data to the NSSP ESSENCE to foster data sharing and collaborative initiatives among public health entities. Military Treatment Facilities (MTFs), housed on DoD installations, provide healthcare to all service members and their beneficiaries stationed in the area. Service members and their beneficiaries represent a substantial portion of the local community and interact with the civilian population throughout daily activities. Sharing syndromic surveillance data between DoD and public health jurisdictions can provide public health situational awareness among both civilian and military populations to support disease surveillance. DoD and VDH engaged in a pilot project to develop processes and procedures for data sharing, data access, and communication with the aim they can serve as best practices for other jurisdictions seeking to share syndromic surveillance data with DoD.

Objective: This panel will focus on the experiences from the Department of Defense (DoD) and Virginia Department of Health (VDH) data sharing project using the National Syndromic Surveillance Program (NSSP) ESSENCE and will discuss lessons learned, challenges, and recommendations within the following areas: 1) data sharing authority, 2) coordination and implementation of data sharing with a focus on personnel, training, and managing access and 3) communication between local, state, and federal agencies.

Block 3 of the US Military Electronic Surveillance System for Early Notification of Community-Based Epidemics (ESSENCE) system affords routine access to multiple sources of data. These include administrative clinical encounter records in the Comprehensive Ambulatory Patient Encounter Record (CAPER), records of filled prescription orders in the Pharmacy Data Transaction Service, developed at the Department of Defense (DoD) Pharmacoeconomic Center, Laboratory test orders and results in HL7 format, and others. CAPER records include a free-text Reason for Visit field, analogous to chief complaint text in civilian records, and entered by screening personnel rather than the treating healthcare provider. Other CAPER data fields are related to case severity. DoD ESSENCE treats the multiple, recently available data sources separately, requiring users to integrate algorithm results from the various evidence types themselves. This project used a Bayes Network approach to create an ESSENCE module for analytic integration, combining medical expertise with analysis of 4 years of data using documented outbreaks.

Objective

The project objective was to develop and test a decision support module using the multiple data sources available in the U.S. DoD version of ESSENCE.